Cardiovascular Common Procedures and Conditions

What is an arrhythmia?

A change in or loss of the regular rate and rhythm of the heartbeat; also called a dysrhythmia.

What symptoms can arrhythmias cause?

Syncope, near syncope, dizziness, fatigue, or palpitations; some patients have no symptoms.

What is sinus tachycardia?

A heart rate greater than 100 beats per minute.

What can cause sinus tachycardia according to the module?

Exercise, infection, pain, anxiety, anemia, thyroid disease, or heart failure.

What is sinus bradycardia?

A heart rate less than 60 beats per minute.

When can sinus bradycardia be normal?

In healthy patients who exercise regularly.

What is atrial fibrillation?

The most common chronic arrhythmia; an irregularly irregular rhythm in which electrical conduction begins from many different locations throughout the atria rather than the SA node.

Why does atrial fibrillation increase stroke risk?

Blood can coagulate within the heart because the atria and ventricles are not moving blood in a coordinated way, and the clot can travel to the brain.

What is ventricular tachycardia?

A fast arrhythmia over 100 beats per minute in which contraction is initiated in the ventricles rather than the atria.

What is cardioversion?

A procedure used to treat life-threatening arrhythmias by applying an electric shock to restore regular heart rate and rhythm.

What is surgical ablation?

A procedure that destroys parts of the atria that are sending irregular electrical signals.

What is a pacemaker?

A device surgically inserted into the chest cavity to stimulate the heart with electronic impulses.

What is coronary artery disease (CAD)?

A disease caused by atherosclerosis, the buildup of fatty material or plaques in the arteries of the heart.

What CAD risk factors are listed in the module?

Positive family history, male sex, abnormal blood lipids, diabetes mellitus, hypertension, physical inactivity, abdominal obesity, cigarette smoking, poor diet, and drinking too much alcohol.

What lifestyle changes can reduce CAD risk factors?

Regular exercise, a healthy diet, weight loss, and smoking cessation.

Why are patients with CAD at higher risk for myocardial infarction?

Plaque can become large enough to decrease blood flow, causing heart muscle to begin to die from lack of blood flow.

What is a myocardial infarction (MI)?

Obstructed blood flow to the heart muscle; also called a heart attack.

What symptoms of MI are listed in the module?

Sudden chest pain at rest, sweating, weakness, anxiety, lightheadedness, shortness of breath, and nausea; one-third of patients may not feel chest pain.

How is an MI assessed in the hospital?

With blood work and an electrocardiogram.

What types of MI can an ECG show?

NSTEMI and STEMI.

What is percutaneous coronary intervention (PCI)?

A procedure in which a catheter is inserted into a large artery in the groin or arm and threaded to the heart to examine the coronary arteries and locate a blockage.

What is angioplasty?

A procedure in which a balloon is inflated at the blockage to compress fatty plaques against the artery walls.

What is stenting?

Placement of an expandable metal mesh in an artery to hold it open.

What is a coronary artery bypass graft (CABG)?

A surgical procedure in which veins are removed from the legs and inserted onto the heart to provide a new route for blood past occlusions.

How does the module define hypertension?

Systolic blood pressure above 140 or diastolic blood pressure above 90 on two subsequent readings on two separate doctor’s office visits.

What conditions does hypertension increase the risk for?

Heart attack, heart failure, stroke, kidney disease, and aortic dissection.

What risk factors for essential hypertension are listed?

Obesity, cigarette smoking, sleep apnea, increased NSAID use, increased salt intake, low potassium intake, excessive alcohol use, sedentary lifestyle, and polycythemia.

What symptoms may occur with hypertension?

Patients are typically without symptoms, although fatigue and headache may occur.

How is hypertension treated according to the module?

Weight reduction, low sodium diet, increased exercise, decreased alcohol intake, and medications to lower blood pressure.

What is heart failure?

Failure of one or both sides of the heart to pump blood effectively to the body tissues, the lungs, or both.

What is left-sided heart failure also called?

Congestive heart failure.

What is systolic dysfunction?

The left ventricle is unable to contract normally.

What is diastolic dysfunction?

The left ventricle walls are unable to relax and fill with blood.

What symptoms are associated with right-sided heart failure?

Lower-extremity edema, liver enlargement, and distended neck veins.

What is ejection fraction?

The percentage of blood pumped out of the ventricles with each heartbeat.

What ejection fraction range is typical in a healthy patient according to the module?

55–70%.

What ejection fractions are described in heart failure?

Less than 40% can occur; below 35% is associated with higher risk for life-threatening conditions such as myocardial infarction or arrhythmia.

What are treatment goals for heart failure?

Reduce blood volume and increase the heart’s ability to pump effectively.

What treatments for heart failure are listed?

Diuretics, medications for hypertension and arrhythmias, implantable defibrillators, and heart transplantation in appropriate patients.

What is peripheral artery disease (PAD)?

A condition in which atherosclerotic plaques build up in arteries outside the heart and restrict blood flow.

What is intermittent claudication?

Pain or cramping in the legs and buttocks while walking that resolves with rest.

What can untreated PAD lead to?

Ischemia of the limbs or kidneys.

How is PAD treated according to the module?

Regular exercise, a heart-healthy diet, smoking cessation, blood-thinning medication, stenting, and angioplasty.

What is valvular disease?

Disease or damage of the heart valves; the aortic valve is the most commonly affected.

What causes of valvular disease are listed?

Aging, hypertension, history of rheumatic fever, infections of the inner lining of the heart, or congenital heart disease.

What is valve regurgitation?

Blood leaks back through a valve to the chamber it came from because the valve no longer closes completely.

What is valve stenosis?

Restricted blood flow because the valve is stiff and narrowed.

What is valve prolapse?

A floppy or loose valve.

What is aortic stenosis?

Stiffening of the aortic valve due to calcium deposits.

What symptoms can develop with aortic stenosis?

Left-sided heart failure, dyspnea, and syncope.

What is a valvuloplasty or valvoplasty?

Surgical repair of a valve.

What is a valvotomy?

An incision into a stenosed valve to relieve obstruction.

How can a diseased heart valve be replaced?

Through a catheter inserted through an artery or through open-heart surgery, using a metal or tissue valve.